Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan.
Several recent clinical trials and meta-analyses have shown that lowering blood pressure reduces the risk of cardiovascular disease. However, current evidence that describes general demographics in blood pressure and mortality with chronic kidney disease is sparse in Japan. Using a population-based...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0225812 |
id |
doaj-ecaad30168024e41a548d2ee07593bce |
---|---|
record_format |
Article |
spelling |
doaj-ecaad30168024e41a548d2ee07593bce2021-03-03T21:19:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022581210.1371/journal.pone.0225812Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan.Kei NagaiKunihiro YamagataKunitoshi IsekiToshiki MoriyamaKazuhiko TsuruyaShouichi FujimotoIchiei NaritaTsuneo KontaMasahide KondoMasato KasaharaYugo ShibagakiKoichi AsahiTsuyoshi WatanabeSeveral recent clinical trials and meta-analyses have shown that lowering blood pressure reduces the risk of cardiovascular disease. However, current evidence that describes general demographics in blood pressure and mortality with chronic kidney disease is sparse in Japan. Using a population-based longitudinal cohort that received annual health checkups in Japan in 2008, hypertensive status, self-reported use of antihypertensive drugs, and prognosis were examined through 2012. Chronic kidney disease was defined as positive proteinuria or estimated glomerular filtration rate <60 ml/min/1.73 m2. Subjects were 40 to 74 years old (n = 227,204) with median 3.6 years follow-up period, and patients with and without chronic kidney disease were analyzed separately (n = 183,586 and n = 43,618, respectively). Cardiovascular disease mortality, comprising coronary heart diseases and stroke as entered in the national death registry using ICD-10 coding, was examined. Among all subjects, 346 deaths (96 in chronic kidney disease and 250 in non-chronic kidney disease) due to cardiovascular disease occurred. Compared with cardiovascular disease mortality in chronic kidney disease patients with untreated normal blood pressure, the multivariable adjusted hazard ratio was 3.08 (95% confidence interval: 1.75-5.41) for those with untreated hypertension, 2.30 (1.31-4.03) for those who became normotensive after treatment, and 3.28 (1.91-5.64) for those who remained hypertensive despite treatment. In non-chronic kidney disease subjects, the ratios were 1.90 (1.33-5.41), 1.95 (1.35-2.80), and 1.77 (1.18-2.66), respectively. These results from a nationwide cohort could be one of representative demographics of controlling blood pressure and cardiovascular disease deaths when treating patients with chronic kidney disease in Japan in recent years. Even after development and spread of anti-hypertensive drugs, preventing development of hypertension is preferable, because any hypertension treatment status comparing untreated normal blood pressure was a risk of cardiovascular mortality at baseline year.https://doi.org/10.1371/journal.pone.0225812 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kei Nagai Kunihiro Yamagata Kunitoshi Iseki Toshiki Moriyama Kazuhiko Tsuruya Shouichi Fujimoto Ichiei Narita Tsuneo Konta Masahide Kondo Masato Kasahara Yugo Shibagaki Koichi Asahi Tsuyoshi Watanabe |
spellingShingle |
Kei Nagai Kunihiro Yamagata Kunitoshi Iseki Toshiki Moriyama Kazuhiko Tsuruya Shouichi Fujimoto Ichiei Narita Tsuneo Konta Masahide Kondo Masato Kasahara Yugo Shibagaki Koichi Asahi Tsuyoshi Watanabe Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. PLoS ONE |
author_facet |
Kei Nagai Kunihiro Yamagata Kunitoshi Iseki Toshiki Moriyama Kazuhiko Tsuruya Shouichi Fujimoto Ichiei Narita Tsuneo Konta Masahide Kondo Masato Kasahara Yugo Shibagaki Koichi Asahi Tsuyoshi Watanabe |
author_sort |
Kei Nagai |
title |
Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. |
title_short |
Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. |
title_full |
Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. |
title_fullStr |
Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. |
title_full_unstemmed |
Antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: A large longitudinal study in Japan. |
title_sort |
antihypertensive treatment and risk of cardiovascular mortality in patients with chronic kidney disease diagnosed based on the presence of proteinuria and renal function: a large longitudinal study in japan. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
Several recent clinical trials and meta-analyses have shown that lowering blood pressure reduces the risk of cardiovascular disease. However, current evidence that describes general demographics in blood pressure and mortality with chronic kidney disease is sparse in Japan. Using a population-based longitudinal cohort that received annual health checkups in Japan in 2008, hypertensive status, self-reported use of antihypertensive drugs, and prognosis were examined through 2012. Chronic kidney disease was defined as positive proteinuria or estimated glomerular filtration rate <60 ml/min/1.73 m2. Subjects were 40 to 74 years old (n = 227,204) with median 3.6 years follow-up period, and patients with and without chronic kidney disease were analyzed separately (n = 183,586 and n = 43,618, respectively). Cardiovascular disease mortality, comprising coronary heart diseases and stroke as entered in the national death registry using ICD-10 coding, was examined. Among all subjects, 346 deaths (96 in chronic kidney disease and 250 in non-chronic kidney disease) due to cardiovascular disease occurred. Compared with cardiovascular disease mortality in chronic kidney disease patients with untreated normal blood pressure, the multivariable adjusted hazard ratio was 3.08 (95% confidence interval: 1.75-5.41) for those with untreated hypertension, 2.30 (1.31-4.03) for those who became normotensive after treatment, and 3.28 (1.91-5.64) for those who remained hypertensive despite treatment. In non-chronic kidney disease subjects, the ratios were 1.90 (1.33-5.41), 1.95 (1.35-2.80), and 1.77 (1.18-2.66), respectively. These results from a nationwide cohort could be one of representative demographics of controlling blood pressure and cardiovascular disease deaths when treating patients with chronic kidney disease in Japan in recent years. Even after development and spread of anti-hypertensive drugs, preventing development of hypertension is preferable, because any hypertension treatment status comparing untreated normal blood pressure was a risk of cardiovascular mortality at baseline year. |
url |
https://doi.org/10.1371/journal.pone.0225812 |
work_keys_str_mv |
AT keinagai antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT kunihiroyamagata antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT kunitoshiiseki antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT toshikimoriyama antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT kazuhikotsuruya antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT shouichifujimoto antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT ichieinarita antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT tsuneokonta antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT masahidekondo antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT masatokasahara antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT yugoshibagaki antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT koichiasahi antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan AT tsuyoshiwatanabe antihypertensivetreatmentandriskofcardiovascularmortalityinpatientswithchronickidneydiseasediagnosedbasedonthepresenceofproteinuriaandrenalfunctionalargelongitudinalstudyinjapan |
_version_ |
1714817530338476032 |